Over the last decade, diabetes technology has boomed. 2025 promises to be an exciting year for the diabetes landscape with the emergence of a brand-new pump company and the ongoing expansion of iCGM (integrated continuous glucose monitor) options for current pump users.
Introducing the twiist insulin pump
Sequel Med Tech developed the twiist insulin pump which incorporates the Tidepool Loop algorithm and is compatible with multiple brands and versions of iCGMs. Although this pump requires a tube, it has various wearing options, similar to Tandem’s current Mobi pump. The twiist pump hopes to provide more setting options, including multiple target ranges and additional options for boluses occurring around exercise.
They have also created advanced insulin delivery technology (using sound waves) to detect issues or occlusions faster than any other pump on the market and to enhance the accuracy of insulin delivery. Twiist has already been approved by the FDA so we hope to see it released to the public this year. Further information about this pump can be found on tcoyd.org or twiist.com.
Omnipod 5 expansion
Mid 2025 we should also see the approval of the Omnipod 5 with Dexcom G7 iPhone app followed by approval for Omnipod 5 with the Freestyle Libre2 Pro iCGMs. Android users already have the option to use the G7 with the app but there has been a lag in the ability to use the phone app with G7 for iPhone users. I would personally like to see some upgrades to their algorithm to allow for more aggressive prevention of both high and low blood sugar but have not heard any talk of upgraded algorithms as of 2025.
Insulin pump users want more options, better access, lower cost and better outcomes, and it's wonderful to see that pump companies are listening and responding to these requests.
Tandem patch pump
Tandem has been working on a patch pump (no tubing required) and hopes to release it this year. Tandem's Mobi was a step in the right direction but both Tandem and Medtronic have realized just how popular patch pumps are. Learn more about Mobi here.
Having worn both patch and tube pumps, I would agree that a pump that adheres to the body makes wearing a pump easier. One of my favorite things about Omnipod is the automated insertion of the cannula which greatly reduces errors in getting insulin into the body and the fact that you don't even see the needle has allowed many with needle-phobia to get the insulin treatment that they need. Of course, I hope that each company continues to minimize the size of these pumps.
Medtronic - changing its game plan
Medtronic has been working on a completely new design for the Simplera iCGM which has already been approved by the FDA as a stand alone device. We are still waiting on FDA approval for this device to be used along with the Medtronic pumps.
If you remember my blog on the Medtronic Guardian 4 sensor, I find it way too complicated to place and use. Lasting an average of 6 days, the Guardian transmitters need to be charged and placement requires multiple steps and multiple hands.
The Simplera has an all-in-one design for the sensor and transmitter similar to the Dexcom G7 and the Libre iCGMs, thus removing the need for overtape and transmitter charging. It is designed to last up to 7 days and does still have a 2-hour warmup period (as does the Guardian 4 and Dexcom G6). As many of you know, 2 hours is a long time to go without sensor data, especially when insulin delivery is reliant on this information but the Simplera is a big step in making Medtronic a easier system to use.
Interestingly, Medtronic is also looking to Abbott to pair the Libre 2 Pro with the Medtronic 780G pump. Historically, Medtronic has not collaborated with other tech companies but they seem to be playing ball now. It seemed obvious to me that other companies are producing much better CGMs than Medtronic has but never did I ever think they would agree with me and start talking with Abbott or Dexcom.
Market Trends
Being from the US, I didn’t realize that the Libre CGMs have the majority of the market for Europe and the rest of the world. Collaboration with Libre means that pump companies not only want to make more options available to users but also that they are planning to continue expanding their global markets. Thus, expect to see Tandem, Omnipod and Medtronic marketing and expanding worldwide.
The overall trend in diabetes technology seems to be focused on enhancing the user's experience, not just their time-in-range or A1c. Users want more options, better access, lower cost and better outcomes, and it's wonderful to see that pump companies are listening and responding to these requests. In fact, in order to keep a competitive edge, pump companies have to offer options or risk losing money.
What this means for the person with diabetes is that we get more options in our hardware which should make managing diabetes that much easier and hopefully, cheaper. Gone are the days of insurance dictating what single device you can have that is on their formulary as we enter a new age of choosing your devices based on what works best for you. For many people this also means better access to AID systems as there is a higher likelihood that insurance will cover ONE of the compatible sensors for the pump chosen.
Make sure you talk with your healthcare team about what challenges you the most with diabetes management and how these devices can address those particular challenges
Having more options can be really confusing, so make sure to talk with your doctor and your diabetes educator to get the details about each device. Make sure you talk with your healthcare team about what challenges you the most with diabetes management and how these devices can address those particular challenges. After all, it's not just about the numbers, it's about living a quality life that centers around you, not around diabetes.
Stay tuned for more diabetes technology information and updates. Comment below, what pump system options are you excited for? Are there other tech options you want?